B.C. announces provincewide colorectal cancer-screening program

Doug Shirlaw drives for the Cancer Society around Vancouver on Nov. 5, 2012. Shirlaw is a former VPD sergeant and cancer survivor.

Photograph by: Ward Perrin
, PNG

A provincewide screening program aimed at detecting colorectal cancers earlier and boosting the number of 50-to-74-year-olds being tested will begin next spring.

It’s expected the program, which includes reminder letters and awareness campaigns, will increase the number of those over age 50 getting tested to at least 70 per cent.

At present, only about one-third of B.C. residents in the 50-to-74 age range are tested.

The B.C. government has been under pressure for several years from the BC Cancer Agency, patient advocacy organizations and the NDP to implement a publicly funded program like those in other provinces.

A three-year pilot project called Colon Check showed the value of an organized screening program like those for breast and cervical cancers. Forty-five cancers and hundreds of pre-cancerous polyps were found in the 15,000 people screened.

A University of B.C. study in the Canadian Medical Association Journal in 2010 also showed that a screening program would drastically lower incidence and death rates.

That study found that for every 100,000 individuals over the age of 50 who are screened, the costs of finding, diagnosing and treating any problems revealed by the tests amount to about $70 million. There are 1.345 million people in B.C. between the ages of 50 and 74.

Health Minister Margaret MacDiarmid, who announced the program at a press conference Monday, said the government doesn’t know what the program will cost because it’s not known how many people will take advantage of the free testing for signs of blood in the stool.

“Hopefully, it will cost a lot,” she said, indicating she hopes more people will get screened.

MacDiarmid, a former family doctor herself, said she’s an “unwilling cancer customer,” having survived breast cancer. But as such, she knows the benefits of screening to detect cancer earlier when it’s easier to treat.

The government’s Medical Services Plan branch already spends more than $30 million a year on colorectal cancer diagnostic exams, including fecal sample tests, colonoscopies, sigmoidoscopies and barium studies. That is likely to jump substantially in an organized program because family doctors will also be recommending testing to patients with no symptoms or risk factors.

Besides the $30 cost of the stool test, there will also be BC Cancer Agency costs for managing and coordinating the program, plus treatment of what’s anticipated to be more cases of cancer being picked up. The cost of treating colorectal cancer — which includes pathology and other lab tests, surgery, doctor visits, chemotherapy and radiation — ranges from about $5,000 to $500,000 per patient each year.

The government plans to place a request for proposals for the home-based, fecal immunochemical test that detects blood shed by pre-cancerous polyps or malignant tumours, MacDiarmid said. Its accuracy in detecting cancerous growths and other bleeding polyps is said to be in the range of about 80 per cent.

The screening program will launch April 1, 2013 on Vancouver Island. Other health regions will roll out programs after that.

Doug Shirlaw, a former Vancouver police department sergeant who was diagnosed with colon cancer soon after he retired at age 51, said he’s pleased the government is finally acting because it should help detect cases earlier. Shirlaw had symptoms, which included lower back and abdominal pain, but he wasn’t diagnosed until a tumour had grown to a large size and spread to lymph nodes.

Cancer-free since 2007, he now serves as a colorectal cancer awareness advocate and as a volunteer driver for the Canadian Cancer Society, shuttling patients to appointments.

In 2012, about 2,900 B.C residents are expected to get a colorectal cancer diagnosis and 1,150 will die from it, making it the third most common cancer in men and women and the second leading cause of cancer death in men (third in women).

The importance of detecting colon cancer in the early stages was demonstrated earlier this year in a study led by Dr. Hamish Hwang, published in the B.C. Medical Journal.

Nearly half of patients with colorectal tumours had their cancers diagnosed when they showed up in the emergency department with severe complications such as hemorrhage, bowel obstruction or perforation, according to the one-year study on patients in Vernon.

We encourage all readers to share their views on our articles and blog posts. We are committed to maintaining a lively but civil forum for discussion, so we ask you to avoid personal attacks, and please keep your comments relevant and respectful. If you encounter a comment that is abusive, click the "X" in the upper right corner of the comment box to report spam or abuse. We are using Facebook commenting. Visit our FAQ page for more information.